qualitative pp65-antigenemia receiving haematopoietic stem cell transplantation as compared to reduces the number of pre-emptively treated children and young adults Use of a DNAemia cut-off for monitoring human cytomegalovirus infection

Abstract We performed a randomised trial comparing the use of quantitative DNAemia versus positive antigenemia for starting pre-emptive anti-human cytomegalovirus (HCMV) therapy in hematopoietic stem cell transplantation (HSCT) recipients. In the DNAemia arm, antiviral therapy was initiated upon reaching a DNAemia cut-off of 10,000 DNA copies/ml whole blood, whereas in the antigenemia arm therapy was started in the presence of a positive antigenemia. Aim of the study was to compare the number of patients treated in the two arms. On the whole, 178 patients (89 in each arm), receiving unmanipulated HSCT from either a relative or an unrelated donor, completed the study. While the incidence of HCMV infection was comparable in DNAemia and antigenemia arms (34% vs 42%, respectively, P=0.259), number of patients treated was significantly lower in the DNAemia arm (18% vs 31%, respectively, P=0.026). No patient developed HCMV disease. The use of a DNAemia cut-off avoids unnecessary anti-viral treatment. From bloodjournal.hematologylibrary.org by guest on June 7, 2013. For personal use only.